Botox vs Fillers: How Do You Know the Right Injectable for You?

With the growing transparency about cosmetic injectables from high-profile individuals and celebrities, you’ve probably heard of Botox and dermal fillers. These procedures are increasingly becoming popular among people who want to look their best by addressing wrinkles, fine lines, and other cosmetic concerns.

Research shows that the global market size for derma fillers is expected to rise to $8.4 billion by 2029, exhibiting a 7.4% CAGR over the forecast period. Further, the global market size for Botox is expected to reach $9.14 billion by 2028, translating to a 6.8% CAGR over the forecast period.

The rising demand for these cosmetic treatments is due to their ability to produce desirable results for people of all ages with minimal invasion. But what are the differences between the two procedures, and how do you know the right one for you?

Your medical experts at BHSkin Dermatology have answers to all your burning questions regarding Botox vs fillers. Keep reading to learn what each does, how it’s administered, the recovery process, side effects, and average costs.

What is Botox, and What Does it Do?

Botox, or botulinum toxin, is a cosmetic injection that temporarily reduces the appearance of static wrinkles on the face. It is among the four popular brands of neurotoxins. Others are Xeomin, Dysport, and Jeuveau. Botox addresses the signs of aging by weakening specific facial muscles, thus reducing muscle movement-borne wrinkles, also known as dynamic wrinkles.

When the neurotoxin is directly injected into a muscle, it temporarily paralyzes the targeted muscle preventing it from receiving nerve messages telling it to contract. This treatment is FDA-approved and considered very safe to use. It ranks as the top non-surgical cosmetic procedure worldwide.

What are Dermal Fillers, and What do they do?

Dermal fillers are injectable cosmetic treatments used to restore volume in the depressions around the jawline and cheekbones, smooth wrinkles, and soften lines in the face. They are also used to plump lips.

The fillers use ingredients such as collagen or hyaluronic acid to add fullness to areas of the face, restoring a more youthful appearance. Other substances used are Polyalkylimide, Polymethyl-methacrylate microspheres (PMMA), Polylactic acid (PLLA), and Calcium hydroxylapatite.

Our bodies naturally produce collagen and hyaluronic acid, but the volumes gradually decrease as we age, making the skin sag while creating depression and wrinkles. Luckily, the volume can be restored thanks to cosmetic injections like fillers.

How are Botox and Fillers Administered?

Botox vs fillers are both administered through injections and are performed at the healthcare provider’s office. You’ll most likely require a consultation for an examination and to discuss your medical history and goals.

Botox

Doctors use a thin needle to inject tiny botulinum toxin amounts into your skin or muscles. The common areas for Botox injection are the forehead, frown lines, crow’s feet, and the “bunny” lines around the nose, all of which have specific injection patterns. Several factors determine the number of injections needed, including the treatment site and the severity of fine lines and wrinkles.

Many patients feel less discomfort during the procedure, but you may want skin numbing beforehand. Your doctor might use one or more numbing methods, like ice, topical anesthesia, or vibration anesthesia, which reduces discomfort through massage.

You may begin to see results between one to three days after treatment. The effect of Botox injections may last three to six months, depending on the problem being treated. Beyond that time, the mobility of muscles begins to return gradually, although the wrinkles appear less pronounced since muscles become weak over time. For maintenance of this effect, you’ll need regular follow-up injections.

Fillers

The doctor starts by cleaning your skin and may apply a cream or lotion with an anesthetic. Using a thin needle, they inject small amounts of fillers under your skin. A local anesthetic usually comes pre-mixed with the dermal filler to numb the skin during and after the procedure. The procedure takes a few minutes or up to an hour, depending on the treatment areas and their severity.

After the procedure, your healthcare provider may give you an ice pack to ease the swelling and pain. The best part about getting dermal fillers is seeing results right after injections. You can be assessed after around four weeks to see if there is a need for further treatments to achieve planned results. Dermal fillers can be temporary or permanent, depending on the type.

Botox vs Fillers Side Effects

Botox is a very safe treatment when administered by a qualified physician. The most common side effects are injection site pain, redness and swelling. Vulnerable people may also experience bruising. Serious complications are rare, but the following may occur:

• Headache
• Injection site infection
• Stroke-like facial paralysis
• Fainting
• Anaphylaxis or life-threatening allergic reaction
• Injection site numbness or altered sensation
• Poor cosmetic outcome
• Botulinum toxicity, with sudden shortness of breath, speech problems and swallowing difficulty as symptoms

Botox is a highly popular FDA-approved treatment. However, you must entrust it only to a highly experienced, board-certified medical professional to avoid these complications.

Like Botox, the most common side effects of dermal fillers are injection site pain, redness and swelling. Bruising can also occur in bruise-prone individuals.

If performed properly, dermal filler injection rarely produces severe complications. However, if done by an unlicensed provider, the following can occur:

• Severe allergies, especially in patients who were given cow (bovine) collagen
• Filler leakage into neighboring areas, signified by lumps and facial lopsidedness
• Skin discoloration
• Severe pain from excessive swelling
• Injection site infection
• Visual changes

Note that not everyone is a good candidate for these cosmetic procedures. If you are pregnant, breastfeeding, have a neurological disease or are allergic to the products used, you shouldn’t get the injections. Calcium hydroxyapatite and other long-lasting dermal fillers may not work in patients with poor inflammatory response.

Botox vs Fillers Recovery

Unlike when you have plastic surgery, there are no wounds to take care of after Botox or filler injections. This makes the recovery process for these treatments shorter and easier. Let’s look at what you should and should not do after each procedure.

Botox Aftercare and Recovery Process

After your Botox procedure, your doctor may advise you not to massage the treated area for a few hours to prevent the spread of the neurotoxin to other parts. It’s okay to resume your routine activities and even wear makeup right after the procedure. However, it would be best if you avoid the following activities in the first four hours after treatment.

• Lying on your back
• Applying heat on the treated area
• Going to the sauna, exercising, excess sun exposure, or other activities that may cause flushing

If you are the kind that bruises easily, these practices may benefit you.

• Put an ice pack on the site every 2-4 hours after the injection, letting it stay on for 15 minutes each time. Icing is more effective within the first 24 hours of treatment.
• Take anti-bruising supplements such as Arnica Montana and Bromelain before and after your Botox appointment.
• Avoid strenuous activities for up to two days after injections. Exercise increases blood flow to the skin and the risk of bruising.
• Use extra pillows under your head when sleeping to control blood flow in the injection site and avoid pressure.
• Avoid facial treatments like hair laser removal and injectables for several days or weeks as they may further traumatize your skin.

Your doctor will also advise you not to use blood thinners, alcohol, and some herbal supplements for a while, as they can cause or accelerate bruising.

Fillers Aftercare and Recovery Process

Your dermatologist will clean your face immediately after the filler injection and may advise you not to touch your face for 6 hours. After this period, you can wash your face with water and a gentle cleanser. It’s ideal to avoid using makeup immediately, but if need be, there are brands like Oxygenetix, which are safe to apply after 6 hours. Here are some of the things to avoid after your treatment.

• Exposing the injection site to intense heat such as sauna or solarium
• Strenuous activities for at least two days
• Alcohol for at least 24 hours
• Pressure on the treated parts for the first two nights
• Using Retinols, AHA, Vitamin C, or oil-based makeup for 24 hours
• Facial waxing, Glycolic peels, microdermabrasion, or energy-based treatments for two weeks

Pain after filler injections is usually mild and sometimes moderate. The following practices will make your recovery process more manageable.

• Take over-the-counter pain relief like paracetamol
• Apply a cool compress for 10 minutes every hour during the first 24 hours after injections to reduce the amount of swelling
• Take Bromelain for preventive bruising and Bruderm or Hirudoid for treatment of bruises
• Massage the filler once the tenderness and pain have resolved, and if advised by your dermatologist
• Add an extra pillow when sleeping to avoid too much pressure

How Much Does Each Treatment Cost?

The cost of getting Botox vs fillers varies widely based on location, the size of the area that requires treatment, and the severity of your wrinkles. Many clinics will charge you depending on the number of units or syringes used to achieve desired results, while a few will charge a flat rate. Usually, insurance doesn’t cover cosmetic procedures meaning you can only pay for your treatment in cash.

You will certainly want to go for a treatment option and a provider that fits within your budget. But you must be careful of providers that have insufficient training and expertise, as they could put your safety and health at risk. The quality of the service should be your top priority. So, ensure you’re getting authentic products administered by a licensed dermatologist to safely achieve beautiful, natural-looking results.

Which Treatment is Right for You

The answer can be either or even both depending on what areas you want to treat. Making a decision between dermal fillers vs. Botox should be done with consideration. As you can probably tell, the two procedures don’t fully overlap regarding what they can treat, meaning they are not interchangeable.

Botox is the obvious choice for dynamic wrinkles and fine lines, while dermal fillers are more appropriate if you want to add volume to areas where collagen is depleted. Fillers are also the ideal option if you want fuller lips.

You can opt to address these issues using both treatments to recapture the smooth skin of your youth. The combination of these treatments can make the greatest impact on your appearance by targeting multiple areas of the face simultaneously. A consultation with a medical professional is critical when deciding the correct procedure for you.

Some Factors you May want to Consider before Making a Decision

• How much can you comfortably spend on the treatments?
• How much discomfort can you endure?
• Do you have any allergies?
• How long do you want the results of the treatments to last?
• Is downtime a concern for you?
• Are there any supplements or drugs you currently take that could interact with the treatments?

Get Expert Botox and Dermal Fillers Treatments at BHSkin Dermatology

While it’s believed that everyone is beautiful in their own way, a little help to restore your youthful look and boost your confidence is vital. Botox vs fillers are non-invasive cosmetic treatments that produce fast results with little or no recovery time. Both procedures are safe so long as a certified plastic surgeon or dermatologist performs them.

At BHSkin Dermatology, we’re passionate about boosting the confidence of our patients through a full range of cosmetic treatments that eliminate the signs of facial aging. Our award-winning skincare specialists take enough time to examine your skin and discuss your concerns and treatment goals before recommending a course of action. By choosing us, you can be sure that you are taking the right steps toward achieving your desired look. Book your appointment today!

Author: Don Mehrabi

Don Mehrabi, MD, FAAD, is LA’s leading board-certified dermatologist who treats patients, builds the BHSkin clinics, and raises three kids. This blog builds on medical studies combined with Dr. Mehrabi's first-hand experiences from practicing in Encino-Tarzana, Glendale, and online